The Comprehensive Health Assessment Program (CHAP)
What is the CHAP?
The Comprehensive Health Assessment Program (CHAP) is designed to help minimise the barriers to healthcare for people with intellectual disability. Developed at The Queensland Centre for Intellectual and Developmental Disability by Professor Nick Lennox, the program is used around Australia by state governments and non-government organisations such as Endeavour Foundation, and is being trialled by other countries.
How the CHAP works
The CHAP tool is a two-part questionnaire requiring collaboration between the person with the intellectual disability, their supporter and their general practitioner (GP). The CHAP is designed to prompt an annual and comprehensive health assessment for adults with intellectual disabilities.
- Part One: A comprehensive health history is completed by the parents, paid support staff and/or the person with intellectual disability, which is then provided to the person’s GP.
- Part Two: Working with the person with intellectual disability and their supporter, the GP fills in the second part of the questionnaire. Here, the GP is prompted to be aware of commonly missed, poorly managed or syndrome specific health conditions, and performs a review of the person’s health. Upon completion, a health action plan is developed by the GP in collaboration with the person, and those involved in providing support to the person.
Professor Lennox discusses the need for comprehensive health assessment in this short video.
Availability of the CHAP
The CHAP is a licenced product with the University of Queensland commercialisation body, UniQuest. For those interested in further information on the CHAP or purchasing the CHAP, click here.
CHAP Research Supported by Endeavour Foundation
The original evaluation of the CHAP was conducted within Endeavour Foundation residential accommodation services throughout Queensland in 1999, with findings supportive of the effectiveness the CHAP tool. This study found increased health promotion and disease prevention in the intervention group compared to the control group. There was a 6.6-fold increase in detection of vision impairment, a 30-fold increase in hearing testing, an increase in immunisation updates, and improvements in women’s health screening. In addition, the CHAP increased detection of new health conditions by 1.6 times. For a complete scientific report on the findings of this study, click here.
Endeavour Foundation supported an additional evaluation study of the CHAP between August 2000 and September 2002. As opposed to the original evaluation study, this study involved Endeavour Foundation clients with intellectual disability living in the community, within the Greater Brisbane area. This study confirmed that the previously demonstrated health benefits of the CHAP could be extended to people living in the community either independently, in shared arrangements (without 24 hour support) or with family/friends. To access the abstract summary of this study, please click here.
This evaluation study also included an evaluation of the Ask Health Diary, a diary designed for ongoing use by people with intellectual disabilities for all their medical consultations (as opposed to the CHAP which is a one-off yearly assessment with a GP). This diary also contains tips to allow people to adequately prepare for all their medical consultations. To learn more about the development of the Ask Health Diary, click here.
CHAP Follow-Up Study
The CHAP has been embedded into the service delivery model of Endeavour Foundation. Since the original evaluation study conducted within Endeavour Foundation in 1999, many of the study participants have received an annual or biennial health assessment using the CHAP. Recently, around one third of these study participants consented to be part of a follow-up study, which involves access to Endeavour Foundation CHAP records from the original evaluation to the present date for the consenting participants, and linkage of this data to health information from state government databases such as the Queensland Hospital Admitted Patient Collection (QHAPDC) and Emergency Department Information System (EDIS). By extracting health information from both the CHAP records and these health databases, this study will be able to evaluate the long-term impact of the CHAP.
Data is currently being compiled for this study, with completion due in July 2018.
National Benefit of the CHAP
The CHAP is an evidence-based health tool that has been developed in the context of the Australian health and disability service systems, and has the highest level of evidence to support its use in Australia. It has been shown to improve the health of people with intellectual disability (by increasing health promotion and screening activities and picking up undiagnosed conditions), and results in better healthcare for people with intellectual disability at the primary level. In light of the National Disability Insurance Scheme (NDIS), this tool is ideal for national implementation; the CHAP connects people with intellectual disability and their family with mainstream health services, which could facilitate a smoother interaction between the NDIS and the healthcare system nationally.